<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Chasejackpot')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-chaseJackpot" data-rule="required" class="form-control" name="row[chaseJackpot]" type="number" value="{$row.chaseJackpot|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Chasecountdown')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-chaseCountDown" data-rule="required" class="form-control" name="row[chaseCountDown]" type="number" value="{$row.chaseCountDown|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Chaseovercheck')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-chaseOverCheck" data-rule="required" class="form-control" name="row[chaseOverCheck]" type="number" value="{$row.chaseOverCheck|htmlentities}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
